Provider Demographics
NPI:1043360373
Name:DIGESTIVE DISEASE SPECIALISTS, P.A.
Entity Type:Organization
Organization Name:DIGESTIVE DISEASE SPECIALISTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAPOLEON
Authorized Official - Middle Name:CAJUCOM
Authorized Official - Last Name:MARCELO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-262-8602
Mailing Address - Street 1:4000 MITCHELLVILLE RD
Mailing Address - Street 2:SUITE 430B
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3104
Mailing Address - Country:US
Mailing Address - Phone:301-262-8602
Mailing Address - Fax:301-805-7784
Practice Address - Street 1:4000 MITCHELLVILLE RD
Practice Address - Street 2:SUITE 430B
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3104
Practice Address - Country:US
Practice Address - Phone:301-262-8602
Practice Address - Fax:301-805-7784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty